Thursday, May 9, 2013

Iraq's elections

If you missed it, last month saw provincial elections in Iraq for 12 of the 18 provinces. Why not all 18?

First up, the KRG is semi-autonomous. There three provinces vote on their own timetable. (They'll hold elections in September.)

That leaves 15. So 3 didn't vote. One is Kirkuk and Nouri's refused to resolve the issues of that disputed region.

When I say refused, I don't mean he can't figure out what to do.

The Iraqi Constitution's Article 140 tells him what to do, to hold a census and referendum on Kirkuk and to do so by the end of 2007.

He became prime minister in the spring of 2006 but has refused to follow the Constitution.

So Kirkuk doesn't get to vote.

That leaves Anbar and Nineveh. And why didn't they vote?

Nouri declared they couldn't.

He insisted they were too violent. Then it was pointed out that Baghdad was actually seeing more violence -- at which point Nouri said they couldn't vote because of chances of fraud.

The only fraud is Nouri al-Maliki. (If Anbar and Nineveh vote, they won't support Nouri. He's very unpopular in those two provinces as the ongoing demonstrations against him show.)

If you read the press before Saturday, the elections were a huge win for Nouri who won 8 provinces. Then came Saturday and it turned out it was 7 provinces that his State of Law won. Nouri wasn't on the ballots. C.I. has repeatedly explained this (before and after the elections).

I know she must get blue in the face from having to go over these things all the time.

The results of Iraq’s provincial elections are in –
and they are far from conclusive. While the ruling State of Law bloc
still leads, it’s clearly not as popular as it was. And various
alliances are being built to challenge it further.

The initial results of Iraq’s recent provincial elections were announced by
the country’s Independent High Electoral Commission or IHEC, the body
responsible for conducting and overseeing the elections, on May 4.

And while the actual voting involved a fairly lacklustre polling day
it seems the results may make for more interesting politics as major
parties must seek coalition partners for local government.

The results have yet to be finalized as various appeals
have yet to be heard. But it seems clear that there will some changes
ahead in provincial government. Provincial authorities are influential
in their own areas, having some control over security, economic
development – and thereby, jobs – and how federal funds are used.

The election results indicate a shift in the balance of
power in Iraqi politics, local political analyst, Ihsan al-Shammari, a
lecturer at Baghdad University, told NIQASH. Al-Shammari thought that
the provincial elections could also be seen as an indicator of how the
country will vote in the next federal elections, due in 2014. “In these
elections, the battles to build coalitions will be fiercer than the
electoral campaigns," he said.

Read the whole thing but my big takeaway was, nope, not a good turnout for State of Law.

Thursday, May 9, 2013. Chaos and violence continue, Nouri stomps his
feet over the possibility of peace to the north, the counterinsurgency
practice in Iraq gets evaluated by a US colonel, we look at WikiLeaks,
Bradley Manning and Lynne Stewart, service organizations offer testimony
at today's Senate Veterans Affairs Committee hearing and more.

Lynne Stewart is a US political
prisoner. For the 'crime' of issuing a press release, she was
eventually tossed in prison. The'crime' happened on Attorney General
Janet Reno's watch. Reno has her detractors who think she was far too
tough as Attorney General. She also has her supporters who see her as a
moderate. No one saw her as 'soft.' Reno had her Justice Department
review what happened. There was no talk of a trial because there was no
crime. No law was broken. The Justice Department imposes guidelines
-- not written by Congress, so not laws -- on attorneys. Lynne was made
to review the guidelines and told not to break it again. That was her
'punishment' under Janet Reno. Bully Boy Bush comes into office and the
already decided incident becomes a way for Attorney General John
Ashcroft to try to build a name for himself. He goes on David
Letterman's show to announce, after 9-11, that they're prosecuting Lynne
for terrorism.

Eventually tossed in prison? Even Bully Boy Bush allowed Lynne to
remain out on appeal. It's only when Barack Obama becomes president
that Lynne gets tossed in prison. It's only under Barack that the US
Justice Depart disputes the judge's sentence and demands a harsher one
(under the original sentence Lynne would be out now). Lynne's cancer
has returned.

Her husband Ralph Poynter and Mya Shone and Ralph Schoenman provide an important update this week:

A major milestone has been reached in the struggle for Lynne
Stewart's freedom. Lynne Stewart wrote on April 26 to confirm that the
Warden at FMC Carswell recommended Compassionate Release to the Federal
Bureau of Prisons.“So Happy that the Compassionate Release was granted at Carswell and we are on the road!!!"Who DID It? --- The People Yes – and we certainly deserve a VICTORY and this is one for sure!!”With this dramatic development, the International Campaign to Save
the Life of Lynne Stewart crossed a critical threshold. We directed our
attention immediately to Charles E. Samuels, Jr., the Director of the
Federal Bureau of Prisons.Following two expedited communications from former Attorney General
Ramsey Clark, a probation officer charged with inspecting the residence
designated for Lynne Stewart's recovery was dispatched to the home of
her son, attorney Geoffrey Stewart. Soon afterwards, we were notified
that the residence was approved.Thus, another hurdle has been overcome, paving the way for Lynne Stewart's Compassionate Release.There is no time to lose. Lynne Stewart has been in quarantine for
several weeks at FMC Carswell since her white blood count dropped
precipitously. As Ramsey Clark wrote to BOP Director Samuels:"Further medical tests reveal that the cancer that had metastasized
rapidly to her lungs, lymph nodes and shoulder remains aggressive. If
the series of chemotherapy treatments slowed its spread in certain
areas, it has not attenuated in her lungs. … The sustained treatment and
preparations by the medical team at Memorial Sloan Kettering Cancer
Center in New York City are critical to her survival.”This is the moment to intensify our global mobilization. We must
prevail upon the director of the Bureau of Prisons to file the motion
for compassionate release with Judge John Koetl, the sentencing judge.ASK FIVE OF YOUR FRIENDS OR COLLEAGUES TO SIGN THE PETITION. PUT THE
PETITION ON YOUR FACEBOOK PAGE AND SEND A TWITTER MESSAGE NOW.Among the latest signers are: Fr. Miguel d’Escoto Brockmann, Bianca
Jagger, Margaret Ratner Kunstler, Mark Lane, Noam Chomsky, Medea
Benjamin, Rosa Clemente, Kathy Kelly, James Ridgeway and William Blum.

Lynne's been there when people have needed her -- everyone from
so-called 'respectable' people to people no one else would help. That's
how she earned the title of "The People's Attorney." She never should
have been put in prison in the first place and she needs to be out now
to get the treatment she needs, to have the support system of her family
and her friends (and a support system is very important when you're
being treated for cancer). She turns 74 this year. She's not a threat
to anyone and she needs to be home.

Julian Assange and WikiLeaks. I referred in the Tuesday snapshot
to how Julian loses his case. A number of people want clarification.
If the goal is to get Julian Assange out of London to Ecuador, then
they're again bungling everything.

Julian Assange is a divisive figure. You may not like that fact if he's
your hero or someone you support but the ugly truth needs to be told
and it needs to be recognized. What his legal team wrongly thinks is
that they can 'humanize' Julian Assange. No.

That will not happen. Assange is not an unknown where the problem is
people just don't know him. He's not a cypher that you can write a new
pattern over. He is a known. And he pisses a number of people off. If
you want him out of the Embassy in London, you need to quit lying and
start recognizing reality.

Before the rape allegations emerged, Julian Assange were already divisive. Long before they emerged, South Parkwas
mocking him (he was a rat). He's also seen as an ego maniac. We can
list all of his negatives but, if you're honest with yourself, you know
how he's seen.

The key to Assange's freedom is not Celebrity Profile Assange!

And every time one of those appears, he looks stupid (and trivial) to
all but his small fan base. That's not enough support. To garner more
support, his legal team needs to grasp that WikiLeaks is more popular
than Julian. When he gives interviews, he needs to be talking about
WikiLeaks. No one needs his thoughts on today's 'hot topics.' He needs
to give interviews where he talks about what WikiLeaks has done but,
most importantly, what WikiLeaks can do, what's up next.

Julian Assange's value is limited. He's one person and not someone who
polls well. (As his legal team knows from repeat polling but they keep
kidding themselves that they're just one soft feature away from
convincing the people that they actually love Assange.) WikiLeaks is
where the value is -- provided WikiLeaks is publishing. WikiLeaks as a
curio from the past? Not going to motivate people. WikiLeaks still
active today (which it is) and that the focus of any Julian Assange
interview is what lets his issues become issues that matter.

You tie him into WikiLeaks, you make the case for WikiLeaks. He doesn't
become more likable in the process but he's off the table. It's no
longer bout what Julian does as Julian Assange it's about what WikiLeaks
does. I've made this argument repeatedly. People nod (I'm thinking of
two of his attorneys) and claim insight. But then we get the nonsense
like the Chris Hedges interview. Chris is going to softball Julian.
He's going to fluff. He's the best (most favorable) interviewer Julian
could have. And Julian and Michael Ratner wasted that interview with
crap like what Julian Assange thinks about gay people in the military.

No one cares. Leave aside that the repeated use of "homosexual"
at a time when most say "gay and lesbian" made it seem as if Julian was
ridiculing gays and lesbians, there was no need for the topic and it
had nothing to do with WikiLeaks. Every time he goes off topic, he
risks saying something offensive and his favorables are so low he can't
afford to turn off any more people.

The topic has to be WikiLeaks. By hard selling its past impact, its
current work and, most important, where the future leads for WikiLeaks,
you're suddenly on the issues that more people care about and you're
making a case for extraditing Assange by sketching out something much
more important than one person.

Matt Sledge (Huffington Post) reports,
"Fed up with the military's limits on access to the court martial of
Bradley Manning, the Army private who has admitted to sending hundreds
of thousands of sensitive documents to the transparency organization
WikiLeaks, a nonprofit group announced Thursday that it is crowdfunding a
court stenographer to create daily trial transcripts." That's a topic
that should have been raised with Chris Hedges. That's the sort of
thing that WikiLeaks needs to be doing.

Vivienne Westwood
revolutionized fashion beginning with the punk movement in the 70s so
she was a natural for the Metropolitan Museum of Art's gala this week
celebrating the exhibit PUNK: Chaos To Courture (which runs through August 14th). Karen Dacre (Evening Standard) reports,
"The inimitable Vivienne Westwood -- a vision in a pale pink kimono and
grey ruched waist dress from her own label -- led the charge. And
rightly so, the British designer is the godmother of the era this whole
evening was devised to celebrate." But not everyone was impressed. Lucy Waterlow (Daily Mail) explains that, on the red carpet, Vivienne was questioned by Vogue's Billy Norwich on a live feed and Norwich quickly cut her off. Norwich was bothered by her brooch and her discussing it. Michael Dickinson (CounterPunch) explains
Vivienne's brooch was a large photo of Bradley Manning with the word
"TRUTH" on it and that Norwich cut her off after Vivienne said:The most important thing is my jewelry, which is a
picture of Bradley Manning. I’m here to promote Bradley. He needs
public support for what’s going on with secret trials and trying to lock
him away. He’s the bravest of the brave, and that’s what I really want
to say more than anything. Because punk, when I did punk all those
years ago, my motive was the same: Justice, and to try to have a better
world. It really was about that. I’ve got different methods nowadays.

The background on whistle blower Bradley Manning. Monday April 5,
2010, WikiLeaks released US
military video of a July 12, 2007 assault in Iraq. 12 people were
killed in the assault including two Reuters journalists Namie Noor-Eldeen and
Saeed Chmagh. Monday June 7,
2010, the US military announced that they had arrested Bradley
Manning and he stood accused of being the leaker of the video. Leila Fadel
(Washington Post) reported in August 2010 that Manning had
been charged -- "two charges under the Uniform Code of Military Justice. The
first encompasses four counts of violating Army regulations by transferring
classified information to his personal computer between November and May and
adding unauthorized software to a classified computer system. The second
comprises eight counts of violating federal laws governing the handling of
classified information." In March, 2011, David S. Cloud
(Los Angeles Times) reported
that the military has added 22 additional counts to the charges including one
that could be seen as "aiding the enemy" which could result in the death penalty
if convicted. The Article 32 hearing took place in December. At the start of
this year, there was an Article 32 hearing and, February 3rd, it was announced
that the government would be moving forward with a court-martial. Bradley has
yet to enter a plea. The court-martial was supposed to begin before the November 2012 election but it was
postponed until after the election so that Barack wouldn't have to run on a
record of his actual actions. Independent.ie adds, "A court martial is set to be held in June at Ford Meade in Maryland,
with supporters treating him as a hero, but opponents describing him as a
traitor." February 28th, Bradley admitted he leaked to WikiLeaks. And why.

Bradley Manning: In attempting to conduct counter-terrorism or CT and
counter-insurgency COIN operations we became obsessed with capturing and
killing human targets on lists and not being suspicious of and avoiding
cooperation with our Host Nation partners, and ignoring the second and
third order effects of accomplishing short-term goals and missions. I
believe that if the general public, especially the American public, had
access to the information contained within the CIDNE-I and CIDNE-A
tables this could spark a domestic debate on the role of the military
and our foreign policy in general as [missed word] as it related to Iraq
and Afghanistan.
I also believed the detailed analysis of the data over a long period of
time by different sectors of society might cause society to reevaluate
the need or even the desire to even to engage in counterterrorism and
counterinsurgency operations that ignore the complex dynamics of the
people living in the effected environment everyday.

The "lessons learned" component of this section provides a clear view
of the military's expectations of how anthropological or cultural
knowledge is to be used to meet military needs. In observing that
"cultural understanding is an endless endeavor that must be overcome
leveraging whatever assets are available," the military's choice of
"leveraging," beautifully clarifies how the military conceptualizes
anthropologists and others providing occupying troops in Iraq with
cultural information: they are seen as priers of knowledge; tools to be
used for the extraction and use of knowledge ("assets") in ways that
military commanders see fit.
It was concerns over this sort of "leveraging" (the functional
use of anthropologists as pry-bars deployed to act upon human and
cultural "assets" used by the military) that recently led the American
Anthropological Association's Executive Board to declare its disapproval
of the military's Human Terrain Systems as "an unacceptable application
of anthropological expertise."
Obviously, the limited scope of this 2004 Center for Army Lessons
Learned report precludes addressing fundamental issues raised by the
Bush administration's reliance on false pretenses to illegally invade
Iraq. Such issues are not among those included with the designated
"Lessons Learned"-because at this level, the army follows rather than
sets policy. But the same cannot be said for the free-agent
anthropologists and other social scientists who are not part of the
military and are now working as contractors on Human Terrain Teams
"leveraging" culture in service of the military occupation of Iraq.
These individuals willfully choose to ignore the ethical alarms being
sounded by their peers as they voluntarily surrender their disciplinary
skills to better "leverage" cultural "assets" for whatever ends the
military dictates.
Given the problems identified in this 2004 report, it makes sense
that the army would strive for a more culturally nuanced occupation;
after all, it is the nature of occupying armies to seek to subjugate and
occupy nations (legally, or illegally) with as little trouble as can be
arranged. But anthropology's abetment of this cause slides it askew
from any central ethical principles of the field, and it reveals
something of the lesser demons of the field's nature. Granted,
anthropology's past has plenty of shameful instances of anthropologists
applying their skills to leverage occupied peoples in colonial and
neocolonial settings, but the common contemporary understanding that
such manipulative leverages are part of a shameful past does not
influence those seeking their fortune outside the ethical standards of
their discipline's mainstream.

[Col Gian Gentile:] [pause] Counterinsurgency is a tactical method, right? And in war,
tactics are never ends in themselves. Tactics are supposed to achieve
some political goal, some higher good, right? What has United States has
achieved in Iraq? Let’s just look at the numbers – not just for the
United States, also Iraq, but first the United States: the government
has spent close to $3 trillion dollars for 8.8 years of occupation and
war in Iraq, has had 4,883 soldiers killed, tens of thousands with life
changing wounds, that many more thousands suffering from PTSD, right?
Then let’s look at the Iraqi side: close to a quarter of a million
killed, close to a million displaced from their original homes, only a
few of them returning. And then, back to the American perspective, we’ve
replaced one dictator, Saddam Hussein, with arguably another, Nouri
al-Malaki, who is allied closely with USA’s regional adversary, Iran. So
looking at all of that, to say the counterinsurgency as a tactical
method has worked – I don’t see how one can justify that based on what
it cost the United States and what outcome has been achieved there.
And then, the other question you’ve asked: did counterinsurgency work
in terms of protecting the population, well, it’s hard to say that
counterinsurgency worked to protect the population if close to a million
Iraqis have been killed. And then, further with that, if you look at
the narrative that tries to show that, once General Petraeus took over
in February 2007, he instilled new, better counterinsurgency methods,
the fact is that in 2007, the number of Iraqi civilians that died at the
hands of American operations and firepower tripled during the surge as
compared to previous years.
So that’s why I say, with all of that: no, counterinsurgency has not worked.

On a possible planned-use of violence in Iraq, Murtaza Hussain (Al Jazeera) offers this:Away from the focus of major news media - numbed
as it has become to stories of unconscionable Iraqi suffering - Iraq
this past April recorded its deadliest month in five years, with over 700 killed in sectarian violence
throughout the country. Describing the aftermath of a deadly car
bombing in his neighbourhood, school teacher Ibrahim Ali gave voice to
the dread and foreboding felt by many Iraqis for their country:

"We asked the students to remain inside the
classrooms because we were concerned about their safety… [they] were
panicking and some of them started to cry…. We have been expecting this
violence against Shiites due to the rising sectarian tension in the
country."

The unacknowledged truth behind the past decade of
bloodletting in Iraq is that the country itself effectively ceased to
exist after the 2003 US invasion. The northern province of Iraqi
Kurdistan is today an independent country
in all but name and is increasingly moving towards formal recognition
of this fact - while Sunni and Shia Iraqis have come to see themselves
more as distinct entities than as part of a cohesive nation. Iraqi
Sunnis, a once-empowered minority, have taken up arms
in recent months against the Shia-dominated government of Nouri
al-Maliki and have staked their terms in a manner which acknowledges the
irredeemable nature of a continued Iraqi state. In the words of Sunni cleric Mohammad Taha at a rally in Samarra:

"Al-Maliki has brought the country to the abyss...
this leaves us with two options: Either civil war or the formation of
our own autonomous region."

There is evidence to suggest that this state of
affairs was not an unintended consequence of the 2003 invasion. The
American architects of the Iraq War - while couching their
justifications for war in the rhetoric of liberation - had for years
previously openly acknowledged and predicted that an invasion would
result in the death of Iraq as a cohesive state. In a follow-up to their
1996 policy paper"A
Clean Break: A New Strategy for Securing the Realm" - a report
published by leading neoconservative intellectuals, including Richard
Perle, Douglas Feith and David Wurmser, which advocated a radical
reshaping of the Middle East using American military power - the
report's authors acknowledged the inevitability of Iraq's demise
post-invasion.

UNESCO Director-General Irina Bokova
today deplored the death of radio journalist Muwaffak al-Ani, who was
killed in an explosion in west Baghdad on Monday 6 May.

“I am saddened and deeply concerned to hear of
the murder of Muwaffak al-Ani,” said the Director-General. “He was one
of Iraq’s best known media voices; a man dedicated to his profession and
determined to pass his knowledge and skills to a new generation of
journalists. He will be sorely missed, in a country emerging from many
years of conflict and trying to rebuild itself.

“In such situations, the media has a special role to
play. Journalists must be allowed to work in safety - to fulfill their
duty of informing the public, and to uphold the right of freedom of
expression. Impunity for crimes against them must not be tolerated, and I
trust the Iraqi authorities will do everything within their power to
bring those responsible for this attack, which also claimed several
other lives, to justice.”

Muwaffak al-Ani was one of Iraq’s longest-serving
broadcasters. He began his career in radio and television in 1962 at
Radio Baghdad and had worked for several of the country’s major networks
since then. He also taught radio journalism.

According to media reports he was killed, along with
his brother and several others, when a bomb exploded outside the
Mansour Mosque in west Baghdad during evening prayer on Monday.

While the United Nations was mourning the loss of one Iraqi journalists today, they were also celebrating the work of three Iraqi journalists:
9 May 2013 – Three Iraqi women journalists have been selected
as the winners of a United Nations contest which seeks to highlight the
everyday challenges faced by women living in the Middle Eastern
country.
The stories submitted by Suha Audah, Enas Jabbar and Shatha
al-Shabibi were selected by an independent panel for their depiction of
women’s situation in Iraq.
Suha Audah’s article describes the pressure of traditional values
on women practicing sports in Mosul, Enas Jabbar relates the suffering
of women subjected to abduction and Shatha al-Shabibi addresses the
sensitive issue of honour crimes, widespread in traditional Iraqi
society.
“The selection was difficult since the quality of the articles
received was high; most stories portrayed brilliantly the challenges
faced by women in Iraq,” said the Secretary-General’s Deputy Special
Representative for Political Affairs, Gyorgy Busztin, who was a member
of the jury.
The three winners received their prizes during a special ceremony
organized at the UN Compound on 1 May, as part of a roundtable
discussion on women and media to mark World Press Freedom Day.
Ms. Audah, a freelance journalist from Mosul, highlighted the
importance of such awards for Iraqi women journalists who are facing
several difficulties in their daily work. “Women should be able to
impose themselves,” she said. “However, when I claim women’s rights,
some people label me as sexist.”
The winning stories were anonymously selected by an independent
panel composed of Mr. Busztin, the head of the Public Information Office
(PIO), Eliana Nabaa, the Senior Political Advisor to UN Assistance
Mission in Iraq (UNAMI) and former
journalist Hussain Hindawi and the representative for the UN Entity for
Gender Equality and the Empowerment of Women (UN Women, Frances Guy.

The PKK's already in Iraq and the whole world knows it. That's why
Nouri's whines about Turkish war planes bombing were never taken
seriously -- he whined in 2006 and then tabled it for two years before
he began whining nonstop, as though he were a baby that had missed a
feeding. Most western media outlets -- CNN, the Times of London, the
Telegraph of London, CBS News, etc -- took their tours of PKK
headquarters by 2006, if not sooner. That meant that traveled to the
mountain area of northern Iraq.

That's the area that the Turkish warplanes would target and they did
that based on intelligence from the US CIA -- a CIA base was set up on
Turkey's southern border as part of the 2011 drawdown. Surveillance
drones fly over Iraq from that location. Raheem Salman, Isabel Coles and Jon Hemming (Reuters) observe, "The central government's ability to intervene directly in the northern
enclave is therefore extremely limited, but Baghdad's statement is the
first indication of its stance on the process that has raised hopes of
peace." Denise Natali (Al-Monitor) offers a look at the PKK and how Natali feels it fits into the KRG:
The last six months, however, have seen a shift in PKK tactics inside
the Kurdistan Region of Iraq. Whereas the PKK leader in Kandil, Murat
Karaliyan, had previously indicated his willingness to work with [Massoud] Barzani
in 2009, he now opposes electing him to a third term as president. The
PKK is using its networks and social media to incite local opposition
against Barzani and the Iraqi Kurdish parties. For instance, it is
encouraging local populations in the Iraqi Kurdish-Iranian border town
of Halabja to criticize the KRG and Barzani for lack of services. One of
the PKK websites has inflammatory photos and remarks about Barzani's
leadership, as well as other KRG political party leaders.
This shift reflects a reaction to Barzani’s growing power — including
his close ties to Erdogan — and his claims or ambitions to become a
leader of all the Kurds, expressed in Kurdish as “president of
Kurdistan,” which the PKK rejects. More specifically, the PKK shift
coincides with the illness of Jalal Talabani, president of Iraq and
leader of the PUK, which has further weakened the PUK and limited any
serious competition for the KDP and Barzani's power. In fact, the rump
of the PUK — known as the "Gang of Four" — may have called for a
separate list in the planned September elections to reflect its
differences and attempts to challenge the KDP. Yet the PUK leadership
continues to support and depend upon Barzani as president, particularly
as a financial patron.
This is why the PKK is now calling for a “Kurdistan supported by
Goran.” Goran remains the only secular Kurdish nationalist party that
seeks to remove Barzani from office while pressing for a parliamentary
and not presidential system for the region. Goran also has indicated its
support for the PKK and affirmed the PYD as the representative of the
Kurds in Syria, posing another direct challenge to Barzani and the KDP.
The PKK-Goran alliance also is based on shared concerns about Turkey’s
regional power and the need to check Erdogan’s influence over Iraqi
Kurds and in Syria.

I have no idea whether Natali missed it or just doesn't believe KRG
President Massoud Barzani on the topic, but we've noted this before and
we'll note it again, Saturday NINA reported
that Barzani issued a statement declaring he had no interest in seeking
a third term and that he had not asked either that the KRG's Presidency
Law (which limits people to two terms as president) or that his term be
extended.

Rick Weidman raised an important issue early on. The Vietnam Veterans
of America classifies a homeless veteran as a veteran without a
permanent home; however, the VA defines a veteran as homeless only if
they are on the street. Weidman pointed out that the first definition
is more accurate and that veterans going from couch to couch to avoid
being on the street are already homeless.

Dr. Wayne Jonas is calling for true integrated health care that would integrate alternative medicine into the process.

Chair Bernie Sanders: Dr. Jonas, let me start with you, if I might.
As you may or may not know, your statement is fairly revolutionary. As I
hear it, what you are suggesting is that what in recent years has been
called "complimentary medicine," alternative medicine, really should be
integrated into our health care system. What you are suggesting is that
if we move aggressively in areas like meditation, acupuncture,
chiropractic care, I suspect nutrition, and other areas, we can ease
suffering for veterans and we can save the system substantial sums of
money because many of these things have limited side effects. Is my
characterization correct and, if so, what would you suggest that we do
with the VA? How aggressive should we be? The VA has already made
efforts in all these areas. They've been probably ahead of the curve
when compared to the medical health care system in general. What would
you like to see the VA do and is my characterization correct.Dr. Wayne Jonas: [. . . Microphone not on] could be correct provided
that these processes are integrated in the proper way, they're not
simply tagged on as if they were another treatment for another condition
and a specialty is created. So my first suggestion is that the VA --
and they have made a lot of progress in these areas -- get outside
help. And what I mean by that is that by definition these things are
not part of the mainstream system -- that's why they're called
complimentary, alternative medicine. They're outside of the way things
are normally done. That means the skills that are part of them are not
normally part of the educational part of the practitioners that are in
the VA. They're not integrated into medical records, for example,
they're not part of the benefit system and they're not tightly linked
to the priorities such as the personalized person-centered care center.
So we'll go into a patient centered medical home -- in the VA that's a
PAC -- and we'll look for whether these practices are even on the radar
screen. In most cases they're not. Or they're on the side -- they're
not fully integrated. We'll go into the distribution system for primary
care enhancement, for example, called the scan system. That
infrastructure is there to do it but you don't see interactive practices
as part of that. There needs to be a retraining program and an
evaluation and quality assurance program that's coordinated with current
existing practices so that they're systematically designed and
evaluated as they're put in to the systems.Chair Bernie Sanders: Are there any health care systems in this
country which are doing a better job than the VA that we can learn
from? Dr. Wayne Jonas: In these areas, there are. And I suggest that the
VA really look at some of those care systems that have demonstrated
improvements in pain, improvement in function, reduction in cost in
those areas. There's a number of them. The Alliance Center for example
up in Chair Bernie Sanders: I'm sorry?Dr. Wayne Jonas: The Alliance Center for example up in Minnesota has
a wonderful in-patient example of how to integrate complimentary
practices into mainstream in a systematic way.Chair Bernie Sanders: And there results have been positive?Dr. Wayne Jonas: Very positive, yes. Reduction in pain, anxiety,
costs, length of stay in the hospital, this type of thing. There are
some examples within the VA also but they tend to be champion driven so
if you have a passionate person in the VA, it's done. Salt Lake City
had a wonderful one, for example, that showed documented and published
major improvements in outcomes, reductions in costs -- including an
impact on homelessness and that type of thing -- through a whole person
integrated practice. But when the medical director of that retired and
left, it largely went away. What happened wasn't embedded into the
system, into the benefits, for example, into the training and the
education of the entire system. So these are the kinds of things that
need to be coordinated.Chair Bernie Sanders: My impression, scientific impression, is that
all over the country, people are gravitating more to these type of
procedures. My impression also, having visited a number of VA centers,
is that many veterans look forward and want to access these types of
alternative treatments. Is that accurate?Dr. Wayne Jonas: That's absolutely right. Surveys done, at least on
the DoD side, and also on the VA side, show that the use of these
practices tends to be even higher in those populations than they are out
in civilian populations. Especially for stress-related pain and those
types of conditions, mental health conditions.Chair Bernie Sanders: The VA and all of us are wrestling with the
epidemic of PTSD, it's a huge problem. You touched in your testimony
that you think there are treatments, alternative treatments. Say a word
on that.Dr. Wayne Jonas: Well I mentioned two. One, a relaxation treatment
that we tested out at Camp Pendleton that was delivered by nurses. It
induced a deep relaxation. It actually involved training skills -- in
other words, training veterans and their families how to do that. We're
doing another one of those programs down at Fort Hood and some VAs that
show improvement in that. Those are the kind of practices that they're
skill based practices. They're not treatments, per se. They're not
something where you have a pill or you have even a needle or a
manipulation where you call a professional. They're self-care
practices. Chair Bernie Sanders: We've done that within the DoD but there's no reason, I presume, that it couldn't be done in the VA?Dr. Wayne Jonas: There are mind, body and relaxation practices going
on in the DoD. Very few of them have been evaluated. There have been
some that have had impact in those areas. They need to be designed with
experts from the outside that get involved, subject matter experts, and
done in coordination with the VA practitioner so that they learn how to
actually deliver them because they're the implementation experts.
That's why a team approach is required in those areas.

Ava will note Committee Chair Bernie Sanders at Trina's site tonight and Kat will report on Ranking Member Richard Burr at her own site.